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G25 Communicating with parents following a suspected adverse drug reaction in a child: who says what and when?
  1. J Arnott1,2,
  2. AJ Nunn2,
  3. H Mannix2,
  4. M Peak1,2,
  5. M Pirmohamed3,
  6. RL Smyth4,5,
  7. MA Turner3,6,
  8. B Young7
  1. 1School of Health, University of Central Lancashire, Preston, UK
  2. 2Research and Development, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
  3. 3Institute of Translational Health, University of Liverpool, Liverpool, UK
  4. 4Institute of Child Health, University College London, London, UK
  5. 5Institute of Child Health, Great Ormond Street Hospital Foundation Trust, London, UK
  6. 6Department of Women’s and Children’s Health, Liverpool Women’s NHS Foundation Trust, Liverpool, UK
  7. 7Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK

Abstract

Aim To pilot a prompt guide to support discussions between clinicians and parents following a suspect adverse drug reaction in a child.

Method We designed the prompt guide in response to the findings from the Adverse Drug Reactions in Children: Qualitative study (ADRIC: QUAL) that identified parents unmet information and communication needs following a suspected ADR in their child. The prompt guide was developed by the ADRIC: QUAL and wider ADRIC study team; reviewed by parent expert advisory groups and expert advisory groups at the Medicines and Health care products Regulatory Agency (MHRA) and the Royal College of Paediatrics and Child Health (RCPCH) medicines committee before being finalised. The prompt guide was piloted at a regional children’s hospital and it is the findings of the pilot study that are reported here.

We identified suspected ADRs in children through daily ward visits. Treating clinicians used the prompt guide during routine conversations with parents about that suspected ADR. Clinicians then took part in a short structured interview.

Results The prompt guide was used 17 times by nurses (n = 9), specialist nurses (n = 4), and doctors (n = 4).

Clinicians who used the prompt guide felt it was easy to use; was helpful in structuring and pacing the discussion; ensured all relevant topics were covered,; and empowered parents.

An unexpected finding was confusion about whether a child had experienced a suspected ADR and this influenced whether discussions with families took place. Where discussions did take place, there was confusion about who communicated with parents. While doctors felt nurses were often the first to recognise, and therefore communicate with parents about suspected ADRs, few nurses recognised their role in this process and their accounts suggest that they are poorly supported in this role.

Conclusion Optimal communication with parents about suspected ADRs in children depends on clinicians recognising a suspected ADR. Nurses potentially play an important role in communicating with families in such situations but they do not always recognise their role and there maybe unmet training needs.

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